Measuring staff perceptions of challenging behaviour: the Challenging Behaviour Attributions Scale (CHABA)

Causal attributions may interact with other variables to determine staff responses to challenging behaviour. Furthermore, staff perceptions of the causes of challenging behaviour are likely to change as a result of theoretical and practical training. However, there is no established simple method for measuring staff attributions that could facilitate research in these areas. The present paper describes the development and preliminary psychometric analysis of the Challenging Behaviour Attributions Scale (CHABA).     

Unexpected potentiation by discriminant benzamide derivatives of stereotyped behaviours elicited by dopamine agonists in mice

Summary Among four stereotyped manifestations that can be simultaneously quantified in mice treated with apomorphine (APO), two of them (climbing and sniffing) emerge at low APO dosages (below 1 mg/kg) whereas licking and sniffing require APO dosages above 6 mg/kg. However, in mice pretreated (either i.p. or i.c.v.) with sulpiride (especially the levo isomer) or (±)amisulpride in moderate dosage stereotyped licking and sniffing are elicited by APO in much lower dosage (0.75 mg/kg). As a consequence, in mice pretreated with these benzamide derivatives and receiving 0.75 mg/kg APO, a biphasic effect was observed: licking and gnawing progressively appear at low dosages, whereas they are progressively abolished at higher dosages.This potentiation of the effects of APO by (±)amisulpride is even more obvious (maximal scores increased) with larger test-doses of the dopamine agonist (up to 5 mg/kg). Amisulpride also allows the emergence of the two stereotyped behaviours in mice receiving other dopamine agonists in subthreshold dosages (Dipropyl 5,6-ADTN, dexamphetamine or cocaine). The potentation of APO is still observed after dopamine depletion by reserpine and -methylparatyrosine, whereas that of dexamphetamine is abolished. In contrast with the benzamide derivatives, haloperidol does not potentiate at any dosage the effect of APO but, at 0.15 mg/kg, suppresses licking and gnawing elicited by 0.75 mg/kg APO in mice pretreated with 6.25 mg/kg amisulpride or veralipride.Among a series of dopamine antagonists belonging to various chemical classes, only a number of discriminant benzamide derivatives (DBD), previously shown to differentially antagonise several APO-induced behavioural manifestations in rats (sulpiride, amisulpride, tiapride, sultopride, DO 701, LUR 2366 but not metoclopramide) potentiate APO (0.75 mg/kg) regarding licking and gnawing. In contrast, potentiation is not observed, even for a higher test dose of APO, with haloperidol, thioproperazine, pimozide, mezilamine, thioridazine or metoclopramide at any dosage tested.For the various DBD, the two stereotyped behaviours emerge at dosages at which climbing starts to be inhibited, suggesting that selective blockade of some inhibitory response to APO is responsible for the potentiation. Among other hypothesis the possibility that the peculiar behavioural properties of DBD is related to their differential recognition of two classes of dopaminergic binding sites is discussed.     

Stakeholder experiences of using online spatial data visualisation tools for local public health decision support: A qualitative study

The distribution of food outlets within towns and cities and the provision of active travel infrastructure have been associated with health behaviours that can contribute to obesity risk. Decision-makers describe a lack of local data and research evidence as a barrier to policy adoption to improve the public's health. Online spatial data visualisation tools created by researchers can help to bridge this gap. We explored stakeholder experiences of using such tools for decision-support, with a focus on facilitators and barriers to use. We conducted 16 qualitative interviews with Public Health, Planning and Transport Planning professionals, who had used two recently-developed tools. Participants described the importance of tools being open access; their use in “story-telling”, particularly to non-experts; and more broadly their use even when imperfect. They expressed that ‘robustness’ of underpinning data was important, however this was not easily defined. Participants employed personal heuristics, principally based on endorsement and developer credibility, to determine suitability for use. We present key learning points for future developers to maximise engagement and impact.     

吸毒人员吸毒方式、性行为特点与HBV感染的关系研究

目的 了解湖南省吸毒人员乙型肝炎病毒(HBV)感染情况以及吸毒方式、性行为特点与HBV感染的关系。方法 采用现况研究，通过整群抽样，随机抽取某男性戒毒所和某女性戒毒所中的吸毒人员，以问卷的方式调查吸毒人员的吸毒方式和性行为特点，并用酶联免疫吸附试验(ELISA)检测血清中HBsAg、抗-HB、HHcAg、抗-HBc、抗-HBc，采用Chi-square检验对数据进行统计分析。结果 吸毒人员HBV感染率为63．2％；静脉注射和非静脉注射吸毒者HBV感染率分别为64．0％和59．4％，两者差异无显著性(P＞0．05)；有婚外性行为和无婚外性行为的吸毒人员HBV感染率分别为65．4％和55．2％，两者差异有显著性(P＜0．05)；不同性伙伴个数HBV感染率比较有显著性差异(P＜0．01)。结论 吸毒人群是HBV的高危人群，静脉吸毒与非静脉吸毒对HBV的感染无显著性差异，婚外性行为是HBV感染的主要危险因素，性伙伴个数是影响HBV感染的重要因素之一。     

The effect of electronic job aid assisted one‐to‐one counselling to support exclusive breastfeeding among 0–5‐month‐old infants in rural Bangladesh

Exclusive breastfeeding (EBF) for the first 6 months has established benefits, yet had slow improvements globally. Little is known about electronic job aid‐assisted counselling to support EBF. As a secondary outcome of a cluster randomized controlled trial in Bangladesh, we assessed the effect of electronic job aid‐supported nutrition counselling and practical demonstration on EBF. We randomized pregnant women to one of five study arms in the trial and followed mother–child dyads until 2 years of age. Community health workers (CHWs) provided breastfeeding counselling with or without prenatal and complementary nutrient supplements in all four intervention arms. The comparison arm continued with the usual practice where mothers could receive nutrition counselling at routine antenatal and postnatal care, and during careseeking for childhood illnesses. We assessed breastfeeding indicators at birth and monthly until the child was 6 months old, in both intervention and comparison arms. To evaluate the effect of nutrition counselling on breastfeeding, we combined all four intervention arms and compared them with the comparison arm. Intervention newborns had half the risk (relative risk [RR]: 0.54, 95% confidence interval [CI]: 0.39, 0.76) of receiving prelacteal feeds than those in the comparison arm. EBF declined steeply in the comparison arm after 3 months of age. EBF was 16% higher in the intervention than the comparison arm at 4 months (RR: 1.16, 95% CI: 1.08, 1.23) and 22% higher at 5 months of age (RR: 1.22, 95% CI: 1.12, 1.33). Maternal background and household characteristics did not modify the intervention effect, and we observed no difference in EBF among caesarean versus vaginal births. Breastfeeding counselling and practical demonstration using an electronic job aid by CHWs are promising interventions to improve EBF and are scalable into existing community‐based programmes.     

Parenting children with neurodevelopmental disorders and/or behaviour problems

Background Parenting behaviours influence child well‐being and development. However, much of the research on parenting behaviours and their correlates has focused on caregivers of healthy, typically developing children. Relatively less is known about the parenting behaviours of caregivers of children with chronic health conditions. Objective To examine and compare three parenting behaviours (positive interactions, consistency and ineffective parenting) among caregivers of children with neurodevelopmental disorders and/or externalizing behaviour problems, before and after accounting for child and family socio‐demographic characteristics. Methods Participants (n= 14 226) were drawn from the National Longitudinal Survey of Children and Youth, a long‐term study of Canadian children that follows their development and well‐being from birth to early adulthood. Children (and their caregivers) were divided into four groups according to the presence of a neurodevelopmental disorder (NDD; n= 815), the presence of an externalizing behaviour problem (EBP; n= 1322), the presence of both conditions (BOTH; n= 452) or neither of these conditions (NEITHER; n= 11 376). Results Caregivers of children in the NEITHER group reported significantly higher positive interaction scores and lower ineffective parenting behaviours than caregivers of children in any of the other three groups. Caregivers of children in the EBP and BOTH groups reported similar levels of consistency, but significantly lower levels than caregivers of NDD or NEITHER children. These associations largely remained after accounting for child and family socio‐demographic characteristics, with two exceptions: caregivers' reports of positive interactions were no longer significantly associated with child's NDD and BOTH conditions. Conclusions Parenting children with multiple health conditions can be associated with less positive, less consistent and more ineffective parenting behaviours. Understanding the factors that are associated with the challenges of caring for these children may require additional research attention.     

An overview of problematic Internet use

Problematic Internet use (PIU), which has become a global social issue, can be broadly conceptualized as an inability to control one's use of the Internet which leads to negative consequences in daily life. The aim of this paper is to give a brief overview of the gradually evolving body of literature on PIU. This shows that the definitions and diagnostic criteria that have been proposed, and the assessment tools that have been developed, stress similarities between PIU, addictive behaviours and impulse-control disorders. Disagreements regarding diagnostic criteria and the lack of large epidemiological studies have resulted in difficulties in establishing the prevalence of PIU in the general population. Studies suggest high comorbidity rates between PIU and numerous psychiatric disorders highlighting the importance of focusing on comorbidity in treatment. There is growing evidence that genetic, personality and individual differences in automatic and controlled aspects of self-regulation may promote the development of PIU. Pharmacological and psychotherapeutic treatments specific to PIU have received limited testing in large, rigorous studies however preliminary evidence suggests that both psychotropic medications (Escitalopram, Naltrexone and Methylphenidate) and cognitive behaviour therapy may have some utility in the treatment of PIU. More research is needed on areas which remain unclear and contribute to the prognosis of PIU, in particular the temporal relationships between psychiatric disorder and PIU, mechanisms of comorbidity and the more subtle psychological changes that occur through Internet use.     

Incorporating Peer Assessments within a Clinical Practicum Course: Insights from a Clinical Faculty Initiative

IntroductionPeer assessments have been used within health professional programs to provide some degree of judgment of professional behavior and to facilitate feedback among peers. In an attempt to further support the clinical learning of our students, the clinical education team at the Odette Cancer Centre initiated a pilot to introduce peer assessments as a part of strategies for learning and engagement within laboratory sessions. The aim of our work was to retrospectively review peer assessments completed during these sessions in an attempt to identify professional behaviors, both positive and negative, and subsequently correlate the assessments with observed behaviors noted, both formally and anecdotally, within clinical faculty assessments. Further to this, our team attempted to explore student perceptions on the impact of peer assessments to their own learning.MethodsStudents in the final year of a 3-year undergraduate medical radiation sciences program were asked to assess their peers during laboratory sessions using a modified version of an assessment tool previously known to the students, the Assessment of Readiness for Clinical tool. Students (N = 14) were required to evaluate each of their peers who participated in the same session and provide supporting comments for their rating. For each student, responses from peer assessors were anonymized and collated. Comments and numerical ratings on the peer assessments were compared. The student assessments were subsequently compared with similar measures extracted from faculty assessments. Students also participated in a debriefing session to provide feedback regarding the integration of these assessments within the learning sessions and the potential impact they had on their own professional behaviors.ResultsThe majority of students rated their peers in all criteria at a score of 2 (performed or surpassed expectations). There was some correlation between numerical ratings and comments written in the assessments. Comments on peer assessments were in concordance with observations extracted from previous assessments by clinical faculty and teachers for 71% of the students. Students expressed a favorable attitude toward the use of the peer assessments but did not find the numerical ratings useful and instead valued supporting constructive comments that cited specific examples for improvement.ConclusionsPeer assessments were found to be of some benefit to the learning of our students, particularly the anecdotal supporting comments that accompanied the ratings. However, their use must be accompanied by formalized training and guidelines to teachers and learners as well as a careful consideration of the tool chosen to ensure the most purposeful impact on behavior change.     

Media Review

Objective: To examine “college drinking culture” and explore alcohol use and other variables among a sample of US college students.

Methods: Bivariate crosstabulation and logistic regression analyses were used to examine associations between alcohol use, gender, Greek membership and risk behaviours among a random sample of 823 undergraduates who completed a health behaviour survey.

Results: Respondents who binged were significantly more likely to be male and belong to a fraternity/sorority. Fraternity bingers were significantly more likely to engage in physical fights (p < 0.05) than non-Greek male bingers. Sorority bingers were significantly more likely to be injured (p < 0.01), drive under the influence of alcohol (DUI) (p < 0.001), be sexually victimised (p < 0.01) and engage in unwanted sex (p < 0.05) than non-Greek female bingers. Fraternity members who binged frequently (≥3 times in 2 weeks) were significantly more likely to DUI (p < 0.01) and engage in unprotected sex (p < 0.05) than were those who binged intermittently. Sorority members who binged frequently were significantly more likely to DUI (p < 0.05) than were those who binged intermittently.

Conclusion: Prevention efforts likely to be effective in changing binge drinking among college students should be gender specific, consider peer drinking norms, target “windows of risk” and be tailored to the campus’ culture of drinking.